title: Alveolar ridge and maxillary sinus augmentation using rhBMP-2: a systematic review.
abstract: OBJECTIVE
  The aim of this systematic review was to evaluate clinical and safety data for recombinant human bone morphogenetic protein-2 (rhBMP-2) in an absorbable collagen sponge (ACS) carrier when used for alveolar ridge/maxillary sinus augmentation in humans.
  
  
  METHODS
  Clinical studies/case series published 1980 through June 2012 using rhBMP-2/ACS were searched. Studies meeting the following criteria were considered eligible for inclusion: >10 subjects at baseline and maxillary sinus or alveolar ridge augmentation not concomitant with implant placement.
  
  
  RESULTS
  Seven of 69 publications were eligible for review. rhBMP-2/ACS yielded clinically meaningful bone formation for maxillary sinus augmentation that would allow placement of regular dental implants without consistent differences between rhBMP-2 concentrations. Nevertheless, the statistical analysis showed that sinus augmentation following autogenous bone graft was significantly greater (mean bone height: 1.6 mm, 95% CI: 0.5-2.7 mm) than for rhBMP-2/ACS (rhBMP-2 at 1.5 mg/mL). In extraction sockets, rhBMP-2/ACS maintained alveolar ridge height while enhancing alveolar ridge width. Safety reports did not represent concerns for the proposed indications.
  
  
  CONCLUSIONS
  rhBMP-2/ACS appears a promising alternative to autogenous bone grafts for alveolar ridge/maxillary sinus augmentation; dose and carrier optimization may expand its efficacy, use, and clinical application.
authors.affiliation: Department of Oral Diagnosis and Surgery - Periodontics, UNESP - Universidade Estadual Paulista, Araraquara Dental School, Araraquara, SP, Brazil; Laboratory for Applied Periodontal & Craniofacial Regeneration, Department of Periodontics and Oral Biology, College of Dental Medicine, Department of Orthopedic Surgery, Medical College of Georgia, Georgia Regents University, Augusta, GA, USA.
authors.forename: Rubens Moreno de
authors.initials: RM
authors.lastname: Freitas
authors.forename: Rubens
authors.initials: R
authors.lastname: Spin-Neto
authors.forename: Elcio
authors.initials: E
authors.lastname: Marcantonio Junior
authors.forename: Luís Antônio Violin Dias
authors.initials: LA
authors.lastname: Pereira
authors.forename: Ulf M E
authors.initials: UM
authors.lastname: Wikesjö
authors.forename: Cristiano
authors.initials: C
authors.lastname: Susin
mesh_terms: D020341:Absorbable Implants; D000540:Alveolar Ridge Augmentation / Q000379:methods*; D055396:Bone Morphogenetic Protein 2 / Q000627:therapeutic use*; D003094:Collagen; D006801:Humans; D010012:Osteogenesis / Q000187:drug effects*; D011994:Recombinant Proteins / Q000627:therapeutic use; D059546:Sinus Floor Augmentation / Q000379:methods*; D016212:Transforming Growth Factor beta / Q000627:therapeutic use*
chemical_list: D055396:Bone Morphogenetic Protein 2; D011994:Recombinant Proteins; D016212:Transforming Growth Factor beta; C499469:recombinant human bone morphogenetic protein-2; D003094:Collagen
keywords: BMP; alveolar ridge augmentation; bone morphogenetic proteins; bone regeneration; maxillary sinus augmentation